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原发性肝癌早期诊断困难,预后很差.早已熟知,肝细胞癌(HCC)与肝炎后肝硬化密切相关,部分可能与有致肝癌特性的乙型肝炎病毒(HBV)感染有关.流行病学研究证明HBV并非HCC的唯一原因.在日本,除食物中含黄曲霉毒素的因素外,慢性非甲非乙型肝炎也是一种致病原因,HCC患者中,40%曾有输血史.无症状HCC的普查70年代初,当AFP测定尚处于研究阶段,Masseyeff以琼脂扩散法检测AFP,普查9000名男性工人,每年3次,连续2年,发现3例AFP阳性的HCC,仅1例为可切除的小肝癌.1973～1977年,在中国29个省,2392个县普查了8亿4千万人群的肿瘤发病率.早期以免疫扩散法在343499人中筛选出147例无症状的AFP增高者,随访2～10个月,88.4%证实为HCC.1971年使用AFP普查HCC,在启东县,1974～1979年普查了1223912人,发现475例HCC,其中35.2%无症状,手术切除患者的2年存活率为69.0%.这些普查均用敏感性低于RIA的检测法,可能还遗漏了部分小肝癌.在南非和中国,AFP普查结果不同.现已知黑人
Early diagnosis of primary liver cancer is difficult with poor prognosis.It is well known that hepatocellular carcinoma (HCC) is closely related to posthepatitic cirrhosis and partly to hepatitis B virus (HBV) infection with hepatocellular carcinoma.Pecology Proving that HBV is not the only cause of HCC In Japan, in addition to aflatoxin-containing foods, chronic non-A, non-B hepatitis is also a cause of death, with 40% of HCC patients having a history of blood transfusions.Asymptomatic HCC Of the census In the early 1970s, while the AFP assay was still in the research phase, Masseyeff tested AFP on an agar diffusion test, censused 9,000 male workers three times a year for two consecutive years and found three AFP-positive HCCs, only one of whom was resectable Of small HCC from 1973 to 1977. The incidence of cancer in 840 million people was surveyed in 2392 counties in 29 provinces of China from 1973 to 1977. Of the 347,499 individuals previously immunostimulated, 147 asymptomatic AFP- , Followed up for 2 to 10 months, 88.4% confirmed HCC in 1971 with the AFP screening of HCC in Qidong County, from 1974 to 1979 census of 1223912 people, found 475 cases of HCC, of which 35.2% were asymptomatic, surgical resection of patients 2 The annual survival rate was 69.0% .All these censuses were detected with a sensitivity lower than the RIA, may still be left Some small hepatocellular carcinoma have been missed. The AFP census results are different in South Africa and China